2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T853,Multisystem Inflammatory Syndrome in Children (MIS-C) is a hyperinflammatory condition with multi-organ involvement, particularly affecting the cardiac and gastrointestinal systems. Although immunomodulatory therapy is standard, treatment approaches vary. This study aimed to evaluate treatment modalities in MIS-C such as methylprednisolone (MP), intravenous immunoglobulin (IVIG), anakinra and therapeutic plasma exchange (TPE) based on clinical severity and laboratory parameters in a prospectively followed cohort. A total of 125 MIS-C patients were included in the study and followed for at least 6 months after discharge. Patients were stratified by severity and treated with various immunomodulatory regimens, including IVIG+MP, IVIG+MP+anakinra, and IVIG+MP+anakinra+TPE. Patients with mild disease and low inflammatory markers (median CRP 9 mg/dL, ferritin 192 µg/dL) received IVIG+MP. Those with higher inflammation (CRP 20-24 mg/dL, ferritin 308-846 µg/dL) without cardio-pulmonary support were treated with IVIG+low-dose-MP+anakinra. Patients with shock, macrophage activation syndrome, or bicytopenia received IVIG+high-dose-MP+anakinra. TPE was added in cases requiring cardio-pulmonary support. Most were discharged without corticosteroids or anakinra; only 11% received a short outpatient prednisolone taper. The mid-term longitudinal assessment of MIS-C patients suggests that timely immunomodulatory therapies, guided by laboratory parameters, promote safe resolution of systemic inflammation and cardiac complications, and shorten treatment duration. Demonstrates that short-term, biomarker-guided use of anakinra and corticosteroids effectively controls hyperinflammation in MIS-C. Highlights that prolonged corticosteroid therapy may not be necessary, even in severe cases. Provides evidence of early cardiac recovery, including resolution of CAAs, without post-discharge steroids. Supports a steroid-sparing treatment approach, reducing risks of long-term immunosuppression. May inform future MIS-C treatment guidelines by minimizing the need for escalation therapy, ECMO, and related complications.31:Te4b,Abstract Background Multisystem Inflammatory Syndrome in Children (MIS-C) is a hyperinflammatory condition with multi-organ involvement, particularly affecting the cardiac and gastrointestinal systems. Although immunomodulatory therapy is standard, treatment approaches vary. This study aimed to evaluate treatment modalities in MIS-C such as methylprednisolone (MP), intravenous immunoglobulin (IVIG), anakinra and therapeutic plasma exchange (TPE) based on clinical severity and laboratory parameters in a prospectively followed cohort. Methods A total of 125 MIS-C patients were included in the study and followed for at least 6 months after discharge. Patients were stratified by severity and treated with various immunomodulatory regimens, including IVIG+MP, IVIG+MP+anakinra, and IVIG+MP+anakinra+TPE. Results Patients with mild disease and low inflammatory markers (median CRP 9 mg/dL, ferritin 192 µg/dL) received IVIG+MP. Those with higher inflammation (CRP 20–24 mg/dL, ferritin 308–846 µg/dL) without cardio-pulmonary support were treated with IVIG+low-dose-MP+anakinra. Patients with shock, macrophage activation syndrome, or bicytopenia received IVIG+high-dose-MP+anakinra. TPE was added in cases requiring cardio-pulmonary support. Most were discharged without corticosteroids or anakinra; only 11% received a short outpatient prednisolone taper. Conclusion The mid-term longitudinal assessment of MIS-C patients suggests that timely immunomodulatory therapies, guided by laboratory parameters, promote safe resolution of systemic inflammation and cardiac complications, and shorten treatment duration. Impact

Demonstrates that short-term, biomarker-guided use of anakinra and corticosteroids effectively controls hyperinflammation in MIS-C.

Highlights that prolonged corticosteroid therapy may not be necessary, even in severe cases.

Provides evidence of early cardiac recovery, including resolution of CAAs, without post-discharge steroids.

Supports a steroid-sparing treatment approach, reducing risks of long-term immunosuppression.

May inform future MIS-C treatment guidelines by minimizing the need for escalation therapy, ECMO, and related complications.

32:T677,The benefit-risk of coronavirus disease 2019 (COVID-19) vaccination in children remains unclear. We evaluated the effects of mRNA vaccines on COVID-19 hospitalization, pericarditis/myocarditis, and MISC-C in children 6-17 years old. The Madrid Health System Registry was linked with 3 databases of the Madrilenian Health Service (primary care, hospital admissions, and pharmacy) to identify eligible children 6-17 years of age. We matched children receiving an mRNA vaccine with 5 controls and compared 240-day risks for vaccines and controls, with bootstrapping to obtain 95% confidence intervals. Effectiveness was defined as 1 minus the risk ratio. All analyses were conducted by age group (6-11 and 12-17 years). In 183,273 vaccinated and 916,365 controls 6-11 years old, the estimated risk difference (95% CI) of COVID-19 hospitalization was -1.2 per 100,000 (-6.6 to 4.0) for vaccinated versus controls; effectiveness 9.0% (-36 to 49). The risk difference of multisystem inflammatory syndrome in children was -1.4 per 100,000 (-4.7 to 2.3); effectiveness 27.0% (-54 to 76). No cases of myocarditis or pericarditis occurred. In 277,561 vaccinated and 1,387,805 controls 12-17 years old, the estimated risk difference of COVID-19 hospitalization was -5.3 per 100,000 (-9.0 to -2.0); effectiveness 45% (18-72). The risk difference of multisystem inflammatory syndrome in children was -1.3 per 100,000 (-3.0 to 0.8), effectiveness 42% (-31 to 83). The risk ratio of pericarditis/myocarditis for vaccinated versus controls was 1.09 (0.60-1.70). The risks and benefits of COVID-19 vaccines were small in a general population of children 6-17 years of age.33:T8f0, Background: The benefit–risk of coronavirus disease 2019 (COVID-19) vaccination in children remains unclear. We evaluated the effects of mRNA vaccines on COVID-19 hospitalization, pericarditis/myocarditis, and MISC-C in children 6–17 years old. Methods: The Madrid Health System Registry was linked with 3 databases of the Madrilenian Health Service (primary care, hospital admissions, and pharmacy) to identify eligible children 6–17 years of age. We matched children receiving an mRNA vaccine with 5 controls and compared 240-day risks for vaccines and controls, with bootstrapping to obtain 95% confidence intervals. Effectiveness was defined as 1 minus the risk ratio. All analyses were conducted by age group (6–11 and 12–17 years). Results: In 183,273 vaccinated and 916,365 controls 6–11 years old, the estimated risk difference (95% CI) of COVID-19 hospitalization was −1.2 per 100,000 (−6.6 to 4.0) for vaccinated versus controls; effectiveness 9.0% (−36 to 49). The risk difference of multisystem inflammatory syndrome in children was −1.4 per 100,000 (−4.7 to 2.3); effectiveness 27.0% (−54 to 76). No cases of myocarditis or pericarditis occurred. In 277,561 vaccinated and 1,387,805 controls 12–17 years old, the estimated risk difference of COVID-19 hospitalization was −5.3 per 100,000 (−9.0 to −2.0); effectiveness 45% (18–72). The risk difference of multisystem inflammatory syndrome in children was −1.3 per 100,000 (−3.0 to 0.8), effectiveness 42% (−31 to 83). The risk ratio of pericarditis/myocarditis for vaccinated versus controls was 1.09 (0.60–1.70). Conclusions: The risks and benefits of COVID-19 vaccines were small in a general population of children 6–17 years of age. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Multisystem Inflammatory Syndrome in Children: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Multisystem Inflammatory Syndrome in Children (condition). Clinician-written summaries and actionable practice insights. 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However, persistent GLS impairment was reported in 13–35.7% of selected cohorts at 6–12 months, and residual LGE on CMR in up to 33% of smaller studies, though the large MUSIC CMR analysis found only 3.5% met Lake Louise criteria at follow-up. Autonomic dysfunction (including POTS in 62.5% of one small retrospective cohort) contributed to persistent symptoms when conventional cardiac evaluation was normal.","limitations":"- Substantial heterogeneity in case definitions, follow-up timing, and diagnostic protocols prevents pooled estimates.\n- Most studies are single-centre with small samples; CMR and CPET often performed only in selected subgroups, introducing referral bias.\n- Long-term prognostic significance of isolated GLS or CMR abnormalities is unknown; no validated discharge criteria exist.","practice_takeaway":"Reserve ongoing cardiology surveillance for children with persistent objective cardiac abnormalities (ventricular dysfunction, arrhythmia, coronary aneurysm, elevated biomarkers); asymptomatic children with normal ECG, echo, and biomarkers at 4–6 weeks can be discharged from routine follow-up. Children with palpitations, orthostatic symptoms, or fatigue but normal conventional cardiac studies should be redirected to autonomic evaluation and rehabilitation rather than escalating cardiac imaging."}},{"doi":"10.1007/s00246-026-04331-y","pmid":"42313127","title":"Long-term CMR Findings in Pediatric COVID-19 Related Myocarditis","journal_title":"Pediatric Cardiology","journal_issn":"0172-0643","published_at":"2026-06-18T00:00:00.000Z","url":"https://doi.org/10.1007/s00246-026-04331-y","source_score":37,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-23T13:25:12.369Z","updated_at":"2026-06-23T13:25:12.369Z","tags":[{"paper_doi":"10.1007/s00246-026-04331-y","tag_type":"age_group","value":"pediatric","value_numeric":null},{"paper_doi":"10.1007/s00246-026-04331-y","tag_type":"category","value":"Cardiac & Cardiovascular Systems","value_numeric":null},{"paper_doi":"10.1007/s00246-026-04331-y","tag_type":"category","value":"Pediatrics","value_numeric":null},{"paper_doi":"10.1007/s00246-026-04331-y","tag_type":"condition","value":"COVID-19-Related Myocarditis","value_numeric":null},{"paper_doi":"10.1007/s00246-026-04331-y","tag_type":"condition","value":"Multisystem Inflammatory Syndrome in Children","value_numeric":null},{"paper_doi":"10.1007/s00246-026-04331-y","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1007/s00246-026-04331-y","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1007/s00246-026-04331-y","tag_type":"modality","value":"Cardiac Magnetic Resonance Imaging","value_numeric":null},{"paper_doi":"10.1007/s00246-026-04331-y","tag_type":"sample_size","value":"n=21","value_numeric":21},{"paper_doi":"10.1007/s00246-026-04331-y","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s00246-026-04331-y","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1007/s00246-026-04331-y","tag_type":"warning","value":"All long-term CMRs (≥365 days) were from MIS-C patients with initial shock presentation, so long-term data may not represent the full spectrum of COVID-19-related pediatric myocarditis.","value_numeric":null},{"paper_doi":"10.1007/s00246-026-04331-y","tag_type":"warning","value":"Only 8 of 21 patients had follow-up CMR; most long-term data derive from this small, potentially severity-biased subgroup.","value_numeric":null},{"paper_doi":"10.1007/s00246-026-04331-y","tag_type":"warning","value":"The 2009 Lake Louise criteria were used uniformly; results may not be directly comparable to studies using the revised 2018 criteria, which incorporate parametric mapping.","value_numeric":null},{"paper_doi":"10.1007/s00246-026-04331-y","tag_type":"warning","value":"The text states 'only 1 out of 4 patients still meeting Lake Louise criteria' in one passage but '1 of 8' in another—the 1/8 figure is consistent with the methods and appears correct; the '4' may be a typographical error in the original manuscript.","value_numeric":null}],"summaries":{"what_studied":"Retrospective single-center study tracking CMR findings in 21 pediatric patients (mean age 13.1 years) with COVID-19-related myocarditis or MIS-C, analyzed at early (<30 days), mid (30–364 days), and long-term (≥365 days) intervals using 2009 Lake Louise criteria.","key_result":"Among 8 patients with serial CMR (median follow-up 347 days), myocardial edema resolved in all, LGE persisted in only 1/8 (13%), pericardial effusion in 1/8 (13%), and only 1/8 (13%) still met Lake Louise criteria; EGE remained common (88%). Across all 30 CMR studies, LGE declined from 46% (early) to 25% (mid) to 0% (long-term). Over a median clinical follow-up of 20 months, no arrhythmias, heart failure, rehospitalizations, or deaths were documented.","limitations":"- Very small sample (n=21; only 8 with follow-up CMR) at a single center limits generalizability and statistical power.\n- Repeat imaging was clinically driven, not protocolized, introducing selection bias toward more severe initial presentations.\n- 2009 Lake Louise criteria used throughout (not the more sensitive 2018 criteria) due to inconsistent availability of parametric mapping.","practice_takeaway":"Children with COVID-19-related myocarditis or MIS-C generally show favorable CMR and clinical recovery—edema resolves and LGE markedly decreases over time, with preserved ventricular function. Persistent EGE on follow-up is common but should be interpreted cautiously, as its clinical significance remains unclear and it is no longer part of the 2018 Lake Louise criteria."}},{"doi":"10.1097/inf.0000000000005271","pmid":"42302739","title":"Burden of COVID-19 in Korean Children: A Retrospective Observational Study Using Real-world Data","journal_title":"Pediatric Infectious Disease Journal","journal_issn":"0891-3668","published_at":"2026-06-17T00:00:00.000Z","url":"https://doi.org/10.1097/inf.0000000000005271","source_score":6,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-28T13:27:18.746Z","updated_at":"2026-06-28T13:27:18.746Z","tags":[{"paper_doi":"10.1097/inf.0000000000005271","tag_type":"age_group","value":"pediatric","value_numeric":null},{"paper_doi":"10.1097/inf.0000000000005271","tag_type":"category","value":"Infectious Diseases","value_numeric":null},{"paper_doi":"10.1097/inf.0000000000005271","tag_type":"category","value":"Pediatrics","value_numeric":null},{"paper_doi":"10.1097/inf.0000000000005271","tag_type":"condition","value":"COVID-19","value_numeric":null},{"paper_doi":"10.1097/inf.0000000000005271","tag_type":"condition","value":"Multisystem Inflammatory Syndrome in Children","value_numeric":null},{"paper_doi":"10.1097/inf.0000000000005271","tag_type":"generic","value":"COVID-19 vaccine","value_numeric":null},{"paper_doi":"10.1097/inf.0000000000005271","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1097/inf.0000000000005271","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1097/inf.0000000000005271","tag_type":"modality","value":"Vaccine","value_numeric":null},{"paper_doi":"10.1097/inf.0000000000005271","tag_type":"sample_size","value":"n=239334","value_numeric":239334},{"paper_doi":"10.1097/inf.0000000000005271","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1097/inf.0000000000005271","tag_type":"study_design","value":"Retrospective Observational Study","value_numeric":null},{"paper_doi":"10.1097/inf.0000000000005271","tag_type":"warning","value":"Study design is labeled 'retrospective observational' based on author description; the use of administrative claims data introduces potential coding and misclassification bias not fully quantified in the abstract.","value_numeric":null},{"paper_doi":"10.1097/inf.0000000000005271","tag_type":"warning","value":"The full text PDF content was not accessible — only publisher permission guidelines were present in the full text section. All structured data is derived exclusively from the abstract and results fields.","value_numeric":null},{"paper_doi":"10.1097/inf.0000000000005271","tag_type":"warning","value":"The limited protective effect of vaccination is flagged but not mechanistically explained in the available text; possible confounders (low uptake, timing, variant mismatch) cannot be ruled out.","value_numeric":null}],"summaries":{"what_studied":"This retrospective study used South Korea's national K-COV-N database to characterize COVID-19 in children aged 1–17 years across 7 epidemic waves (January 2020–August 2023), assessing the impact of age, comorbidities, and vaccination on disease severity.","key_result":"Among 239,334 pediatric cases, 97.88% occurred during Omicron-dominant waves (5–7). Mean hospital stay fell from 12.6 days (wave 1) to 3.7 days (wave 5), yet mortality and MIS-C were concentrated in the Omicron era. Children aged 1–4 had the worst outcomes. Key severity risk factors: cardiovascular disease (AOR 3.97), neurologic disorders (AOR 2.88), and obesity (AOR 2.68). Vaccination showed limited protective effect against severe outcomes after adjusting for age and sex.","limitations":"- Retrospective design using administrative claims data limits causal inference and may introduce coding inaccuracies.\n- Vaccination analysis showed only limited protective effects, which the authors note but do not fully explain—confounding by indication or low uptake may be a factor.\n- The full text was not available for review; findings are drawn solely from the abstract and results section.","practice_takeaway":"Prioritize close monitoring and targeted protection for children aged 1–4 and those with cardiovascular disease, neurologic disorders, or obesity, as these groups face the highest risk of severe pediatric COVID-19. Healthcare systems should plan for high absolute case volumes during future Omicron-like surges, even when per-case severity is lower."}},{"doi":"10.1542/peds.2025-075578","pmid":"42264467","title":"Long-Term Outcomes of Multisystem Inflammatory Syndrome in Children up to 4.5 Years After COVID-19","journal_title":"Pediatrics","journal_issn":"0031-4005","published_at":"2026-06-10T00:00:00.000Z","url":"https://doi.org/10.1542/peds.2025-075578","source_score":94,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-16T13:54:39.528Z","updated_at":"2026-06-16T13:54:39.528Z","tags":[{"paper_doi":"10.1542/peds.2025-075578","tag_type":"age_group","value":"pediatric","value_numeric":null},{"paper_doi":"10.1542/peds.2025-075578","tag_type":"category","value":"Pediatrics","value_numeric":null},{"paper_doi":"10.1542/peds.2025-075578","tag_type":"condition","value":"Cardiovascular Disorders","value_numeric":null},{"paper_doi":"10.1542/peds.2025-075578","tag_type":"condition","value":"Chronic Kidney Disease","value_numeric":null},{"paper_doi":"10.1542/peds.2025-075578","tag_type":"condition","value":"COVID-19","value_numeric":null},{"paper_doi":"10.1542/peds.2025-075578","tag_type":"condition","value":"Hypertension","value_numeric":null},{"paper_doi":"10.1542/peds.2025-075578","tag_type":"condition","value":"Multisystem Inflammatory Syndrome in Children","value_numeric":null},{"paper_doi":"10.1542/peds.2025-075578","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1542/peds.2025-075578","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1542/peds.2025-075578","tag_type":"sample_size","value":"n=14363","value_numeric":14363},{"paper_doi":"10.1542/peds.2025-075578","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1542/peds.2025-075578","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1542/peds.2025-075578","tag_type":"warning","value":"MIS-C group is relatively small (n=173), so hazard ratio confidence intervals for rarer outcomes (e.g., CKD) are very wide and should be interpreted cautiously.","value_numeric":null},{"paper_doi":"10.1542/peds.2025-075578","tag_type":"warning","value":"Sex distribution within the MIS-C and control groups was not reported in the abstract; the 'mixed' sex tag is an assumption based on population type.","value_numeric":null},{"paper_doi":"10.1542/peds.2025-075578","tag_type":"warning","value":"Study is from a single urban U.S. health system, which may not reflect outcomes in other geographic or demographic populations.","value_numeric":null},{"paper_doi":"10.1542/peds.2025-075578","tag_type":"warning","value":"The total sample size (n=14,363) is derived by combining MIS-C (n=173) and non-MIS-C (n=14,190) groups as reported; the matched analytic sample may be smaller but is not separately specified in the abstract.","value_numeric":null}],"summaries":{"what_studied":"Long-term multisystem outcomes in patients <21 years with MIS-C (n=173) vs. without MIS-C (n=14,190) up to 4.5 years post-COVID-19, using propensity score matching and Cox regression in a single U.S. health system (March 2020–August 2024).","key_result":"MIS-C was associated with markedly elevated risks of cardiovascular disorders (aHR 13.88), hypertension (aHR 8.86), gastrointestinal disorders (aHR 9.48), respiratory disorders (aHR 3.46), and neurological disorders (aHR 2.02) vs. controls; Kaplan-Meier persistent event rates ranged from 6.8% (CKD) to 35.2% (respiratory disorders) in the MIS-C group.","limitations":"- Single health system (Montefiore), limiting generalizability.\n- MIS-C ascertainment relied on ICD-10 codes plus CDC/WHO criteria, which may introduce misclassification.\n- MIS-C group was small (n=173), reducing power to detect rarer outcomes.","practice_takeaway":"Children who had MIS-C face broad, lasting multisystem morbidity — not a transient illness — warranting structured long-term follow-up including routine BP monitoring, neurological and mental-health screening, and cardiovascular and renal surveillance. Preexisting hypertension and diabetes are key risk factors that should intensify the level of post-MIS-C surveillance."}},{"doi":"10.1016/j.jaci.2026.02.048","pmid":"42155682","title":"Circulating Extracellular Vesicles Drive Innate Immune Dysregulation in MIS-C","journal_title":"Journal of Allergy and Clinical Immunology","journal_issn":"0091-6749","published_at":"2026-05-18T00:00:00.000Z","url":"https://doi.org/10.1016/j.jaci.2026.02.048","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-31T13:35:39.239Z","updated_at":"2026-05-31T13:35:39.239Z","tags":[{"paper_doi":"10.1016/j.jaci.2026.02.048","tag_type":"age_group","value":"pediatric","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.02.048","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.02.048","tag_type":"condition","value":"COVID-19","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.02.048","tag_type":"condition","value":"Multisystem Inflammatory Syndrome in Children","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.02.048","tag_type":"generic","value":"SARS-CoV-2 Spike antigen","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.02.048","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.02.048","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.02.048","tag_type":"modality","value":"Cytokine Multiplex Assay","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.02.048","tag_type":"modality","value":"Extracellular Vesicle Profiling","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.02.048","tag_type":"modality","value":"Proteomics","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.02.048","tag_type":"study_design","value":"Prospective Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.02.048","tag_type":"warning","value":"Sample size (total N) is not reported in the abstract or results sections; the sample_size tag could not be populated.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.02.048","tag_type":"warning","value":"Study design is described as a prospective cohort but lacks randomization; level of evidence set to 3 (cohort study).","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.02.048","tag_type":"warning","value":"The impact_flag 'safety_signal' was applied because the study identifies a distinct and potentially underrecognized immune dysregulation mechanism (IRF-biased EV signaling) in MIS-C, though this is mechanistic/translational rather than a direct adverse event signal.","value_numeric":null}],"summaries":{"what_studied":"A prospective cohort study comparing humoral responses, cytokine profiles, and extracellular vesicle (EV) signatures in children with MIS-C versus pediatric COVID-19 (asymptomatic, mild/moderate, severe) and healthy controls, using ELISA, multiplex cytokine assays, size-exclusion chromatography, reporter cell functional assays, and LC-MS/MS proteomics.","key_result":"MIS-C patients had higher anti-Spike/RBD IgG with sustained titers, prominent IL-17A and IL-22 elevation vs. severe COVID-19, and plasma EVs bearing Spike/RBD antigen that preferentially activated IRF (not NF-κB) signaling; EV proteomics revealed a MIS-C-specific cargo enriched for innate immune, neutrophil degranulation, and adhesion/integrin pathways.","limitations":"Sample size not reported in the abstract, limiting power estimates; single-center prospective cohort design may limit generalizability; causality between EVs and MIS-C immunopathology is inferred from functional assays rather than interventional proof.","practice_takeaway":"MIS-C displays a distinct Th17-skewed, IRF-biased inflammatory signature driven in part by antigen-bearing circulating EVs — distinct from severe pediatric COVID-19. Clinicians should consider IL-17 pathway activity and EV-associated biomarkers as potential targets or diagnostic tools when evaluating and managing MIS-C."}},{"doi":"10.1097/inf.0000000000005259","pmid":"42108528","title":"Long COVID-19 in Hospitalized and Ambulatory Children in Jamaica","journal_title":"Pediatric Infectious Disease Journal","journal_issn":"0891-3668","published_at":"2026-05-11T00:00:00.000Z","url":"https://doi.org/10.1097/inf.0000000000005259","source_score":13,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-15T13:23:15.426Z","updated_at":"2026-05-15T13:23:15.426Z","tags":[{"paper_doi":"10.1097/inf.0000000000005259","tag_type":"age_group","value":"pediatric","value_numeric":null},{"paper_doi":"10.1097/inf.0000000000005259","tag_type":"category","value":"Immunology","value_numeric":null},{"paper_doi":"10.1097/inf.0000000000005259","tag_type":"category","value":"Infectious Diseases","value_numeric":null},{"paper_doi":"10.1097/inf.0000000000005259","tag_type":"category","value":"Pediatrics","value_numeric":null},{"paper_doi":"10.1097/inf.0000000000005259","tag_type":"condition","value":"Long COVID","value_numeric":null},{"paper_doi":"10.1097/inf.0000000000005259","tag_type":"condition","value":"Multisystem Inflammatory Syndrome in Children","value_numeric":null},{"paper_doi":"10.1097/inf.0000000000005259","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1097/inf.0000000000005259","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1097/inf.0000000000005259","tag_type":"study_design","value":"Retrospective Observational Cohort Study","value_numeric":null},{"paper_doi":"10.1097/inf.0000000000005259","tag_type":"warning","value":"Follow-up duration for Long COVID assessment is not specified, which limits interpretation of the 47.3% incidence figure.","value_numeric":null},{"paper_doi":"10.1097/inf.0000000000005259","tag_type":"warning","value":"Sample size (total N) is not reported in the abstract; a sample_size tag could not be generated.","value_numeric":null},{"paper_doi":"10.1097/inf.0000000000005259","tag_type":"warning","value":"Sex distribution of the study population is not reported in the abstract.","value_numeric":null},{"paper_doi":"10.1097/inf.0000000000005259","tag_type":"warning","value":"Study design label is based on abstract description; full-text confirmation is recommended.","value_numeric":null}],"summaries":{"what_studied":"This retrospective observational cohort study in Jamaica evaluated acute illness predictors of Long COVID-19 in hospitalized and ambulatory children, using Poisson regression to identify univariate and multivariable predictors.","key_result":"Long COVID-19 incidence was 47.3% in the pediatric cohort. Multivariable predictors included MIS-C, vomiting, and ageusia; univariate predictors also included abdominal pain, anosmia, fatigue, confusion, and brain fog.","limitations":"Retrospective design limits causal inference. Study is from a single resource-constrained setting (Jamaica), which may limit generalizability. Sample size and follow-up duration are not specified in the abstract.","practice_takeaway":"Nearly half of children with COVID-19 in this Jamaican cohort developed Long COVID — clinicians should watch for MIS-C, vomiting, and ageusia as early warning signs. Screening and follow-up protocols for Long COVID are especially needed in resource-limited pediatric settings."}},{"doi":"10.1093/cid/ciag259","pmid":"42037548","title":"Multisystem inflammatory syndrome in children (MIS-C), United States, 2023–2024","journal_title":"Clinical Infectious Diseases","journal_issn":"1058-4838","published_at":"2026-04-27T00:00:00.000Z","url":"https://doi.org/10.1093/cid/ciag259","source_score":15,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-11T13:21:01.460Z","updated_at":"2026-05-11T13:21:01.460Z","tags":[{"paper_doi":"10.1093/cid/ciag259","tag_type":"age_group","value":"pediatric","value_numeric":null},{"paper_doi":"10.1093/cid/ciag259","tag_type":"category","value":"Infectious Diseases","value_numeric":null},{"paper_doi":"10.1093/cid/ciag259","tag_type":"condition","value":"Multisystem Inflammatory Syndrome in Children","value_numeric":null},{"paper_doi":"10.1093/cid/ciag259","tag_type":"generic","value":"COVID-19 vaccine","value_numeric":null},{"paper_doi":"10.1093/cid/ciag259","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1093/cid/ciag259","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1093/cid/ciag259","tag_type":"modality","value":"Vaccine","value_numeric":null},{"paper_doi":"10.1093/cid/ciag259","tag_type":"study_design","value":"Surveillance Study / Epidemiological Analysis","value_numeric":null},{"paper_doi":"10.1093/cid/ciag259","tag_type":"warning","value":"Full text not available — key data such as total sample size, demographic breakdown, severity outcomes, and statistical comparisons are absent from the abstract. Tags and summary are based solely on abstract-level information.","value_numeric":null},{"paper_doi":"10.1093/cid/ciag259","tag_type":"warning","value":"Impact flag 'practice_changing' applied cautiously — the 99% unvaccinated finding strongly reinforces vaccination, but full study quality cannot be confirmed from the abstract alone.","value_numeric":null},{"paper_doi":"10.1093/cid/ciag259","tag_type":"warning","value":"Study design label inferred as surveillance/epidemiological analysis; exact methodology (e.g., registry, passive surveillance) is not specified in the abstract.","value_numeric":null}],"summaries":{"limitations":"Abstract only — sample size, severity outcomes, and detailed demographic breakdowns are not reported here. Surveillance-based data may undercount milder or unrecognized cases.","practice_takeaway":"MIS-C continues to occur almost exclusively in unvaccinated or undervaccinated children. Ensuring children are up-to-date with COVID-19 vaccination remains a key preventive strategy.","what_studied":"Analysis of sporadic MIS-C cases in the United States during 2023–2024, examining clinical presentation trends and COVID-19 vaccination status among vaccine age-eligible children.","key_result":"Clinical presentation of MIS-C showed little change between 2023 and 2024. Among vaccine age-eligible children with MIS-C, 99% were not up-to-date with COVID-19 vaccination."}},{"doi":"10.1038/s41390-025-04706-6","pmid":"41519951","title":"Multisystem Inflammatory Syndrome in Children with tailored therapy and six-month outcome","journal_title":"Pediatric Research","journal_issn":"0031-3998","published_at":"2026-01-11T00:00:00.000Z","url":"https://doi.org/10.1038/s41390-025-04706-6","source_score":21,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-01-12","doi":"10.1038/s41390-025-04706-6","days":"7","issn":"0031-3998","rank":"6","field":"Clinical Medicine","score":"21","category":"Pediatrics","categories":["Pediatrics"],"_categories":["Pediatrics"]},"pubmed":{"doi":"10.1038/s41390-025-04706-6","title":"Multisystem Inflammatory Syndrome in Children with tailored therapy and six-month outcome.","journal":"Pediatric research","methods":"","results":"Patients with mild disease and low inflammatory markers (median CRP 9 mg/dL, ferritin 192 µg/dL) received IVIG+MP. Those with higher inflammation (CRP 20-24 mg/dL, ferritin 308-846 µg/dL) without cardio-pulmonary support were treated with IVIG+low-dose-MP+anakinra. Patients with shock, macrophage activation syndrome, or bicytopenia received IVIG+high-dose-MP+anakinra. TPE was added in cases requiring cardio-pulmonary support. Most were discharged without corticosteroids or anakinra; only 11% received a short outpatient prednisolone taper.","abstract":"$30","keywords":[],"pubmed_id":"41519951","conclusions":"The mid-term longitudinal assessment of MIS-C patients suggests that timely immunomodulatory therapies, guided by laboratory parameters, promote safe resolution of systemic inflammation and cardiac complications, and shorten treatment duration.","publication_date":"2026-01-11T00:00:00"},"crossref":{"DOI":"10.1038/s41390-025-04706-6","URL":"https://doi.org/10.1038/s41390-025-04706-6","ISSN":["0031-3998","1530-0447"],"link":[{"URL":"https://www.nature.com/articles/s41390-025-04706-6.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https://www.nature.com/articles/s41390-025-04706-6","content-type":"text/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https://www.nature.com/articles/s41390-025-04706-6.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Multisystem Inflammatory Syndrome in Children with tailored therapy and six-month outcome"],"author":[{"given":"Osman Oguz","family":"Demir","sequence":"first","affiliation":[]},{"given":"Kubra","family":"Aykac","sequence":"additional","affiliation":[]},{"given":"Arthur Hoi Hin","family":"Cheng","sequence":"additional","affiliation":[]},{"given":"Selman","family":"Kesici","sequence":"additional","affiliation":[]},{"given":"H. Hakan","family":"Aykan","sequence":"additional","affiliation":[]},{"given":"Yelda","family":"Bilginer","sequence":"additional","affiliation":[]},{"given":"Ali Bulent","family":"Cengiz","sequence":"additional","affiliation":[]},{"given":"Rae S. M.","family":"Yeung","sequence":"additional","affiliation":[]},{"given":"Yasemin","family":"Ozsurekci","sequence":"additional","affiliation":[]},{"given":"Seza","family":"Ozen","sequence":"additional","affiliation":[]}],"issued":{"date-parts":[[2026,1,10]]},"member":"297","prefix":"10.1038","source":"Crossref","volume":null,"created":{"date-time":"2026-01-10T20:15:19Z","timestamp":1768076119000,"date-parts":[[2026,1,10]]},"indexed":{"date-time":"2026-01-11T23:51:19Z","timestamp":1768175479004,"date-parts":[[2026,1,11]]},"license":[{"URL":"https://creativecommons.org/licenses/by/4.0","start":{"date-time":"2026-01-10T00:00:00Z","timestamp":1768003200000,"date-parts":[[2026,1,10]]},"delay-in-days":0,"content-version":"tdm"},{"URL":"https://creativecommons.org/licenses/by/4.0","start":{"date-time":"2026-01-10T00:00:00Z","timestamp":1768003200000,"date-parts":[[2026,1,10]]},"delay-in-days":0,"content-version":"vor"}],"subject":[],"abstract":"$31","language":"en","relation":{},"resource":{"primary":{"URL":"https://www.nature.com/articles/s41390-025-04706-6"}},"subtitle":[],"assertion":[{"name":"received","group":{"name":"ArticleHistory","label":"Article History"},"label":"Received","order":1,"value":"13 May 2025"},{"name":"revised","group":{"name":"ArticleHistory","label":"Article History"},"label":"Revised","order":2,"value":"28 August 2025"},{"name":"accepted","group":{"name":"ArticleHistory","label":"Article History"},"label":"Accepted","order":3,"value":"20 November 2025"},{"name":"first_online","group":{"name":"ArticleHistory","label":"Article History"},"label":"First Online","order":4,"value":"10 January 2026"},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"},"order":1,"value":"The authors declare no competing interests."}],"deposited":{"date-time":"2026-01-11T21:07:19Z","timestamp":1768165639000,"date-parts":[[2026,1,11]]},"issn-type":[{"type":"print","value":"0031-3998"},{"type":"electronic","value":"1530-0447"}],"published":{"date-parts":[[2026,1,10]]},"publisher":"Springer Science and Business Media LLC","reference":[{"DOI":"10.1016/S0140-6736(20)31094-1","key":"4706_CR1","year":"2020","issue":null,"author":"S Riphagen","volume":"395","first-page":"1607","unstructured":"Riphagen, S., Gomez, X., Gonzalez-Martinez, C., Wilkinson, N. & Theocharis, P. 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Treatment intensity was guided by CRP and ferritin (mild: CRP 9 mg/dL, ferritin 192 µg/dL; higher inflammation without cardio-pulmonary support: CRP 20–24 mg/dL, ferritin 308–846 µg/dL; shock/MAS/bicytopenia or cardio-pulmonary support prompted escalation including high-dose MP, anakinra, and TPE).","limitations":"Severity-guided treatment allocation in this prospective cohort limits causal inference between regimens. The abstract provides few outcome metrics (e.g., no event rates for cardiac recovery, ICU/ECMO use, or adverse events).","practice_takeaway":"When treating MIS-C, use CRP, ferritin, and clinical severity to tailor short-course IVIG+MP±anakinra, reserving TPE for cardio-pulmonary support. Prolonged post-discharge steroids may be unnecessary, as only 11% needed a brief taper."}},{"doi":"10.1097/inf.0000000000005109","pmid":"41398446","title":"Effectiveness and Safety of COVID-19 mRNA Vaccines in Children 6–17 Years Old: A Population-Based Study in Madrid","journal_title":"Pediatric Infectious Disease Journal","journal_issn":"0891-3668","published_at":"2025-12-16T00:00:00.000Z","url":"https://doi.org/10.1097/inf.0000000000005109","source_score":42,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2025-12-16","doi":"10.1097/inf.0000000000005109","days":"30","issn":"0891-3668","rank":"8","field":"Clinical Medicine","score":"42","category":"Infectious Diseases","categories":["Infectious Diseases"],"_categories":["Infectious Diseases"]},"pubmed":{"doi":"10.1097/INF.0000000000005109","title":"Effectiveness and Safety of COVID-19 mRNA Vaccines in Children 6-17 Years Old: A Population-Based Study in Madrid.","journal":"The Pediatric infectious disease journal","methods":"","results":"In 183,273 vaccinated and 916,365 controls 6-11 years old, the estimated risk difference (95% CI) of COVID-19 hospitalization was -1.2 per 100,000 (-6.6 to 4.0) for vaccinated versus controls; effectiveness 9.0% (-36 to 49). The risk difference of multisystem inflammatory syndrome in children was -1.4 per 100,000 (-4.7 to 2.3); effectiveness 27.0% (-54 to 76). No cases of myocarditis or pericarditis occurred. In 277,561 vaccinated and 1,387,805 controls 12-17 years old, the estimated risk difference of COVID-19 hospitalization was -5.3 per 100,000 (-9.0 to -2.0); effectiveness 45% (18-72). The risk difference of multisystem inflammatory syndrome in children was -1.3 per 100,000 (-3.0 to 0.8), effectiveness 42% (-31 to 83). 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Vaccine","value_numeric":null},{"paper_doi":"10.1097/inf.0000000000005109","tag_type":"sample_size","value":"n=2,765,004","value_numeric":2765004},{"paper_doi":"10.1097/inf.0000000000005109","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1097/inf.0000000000005109","tag_type":"warning","value":"Design labeled as a retrospective cohort based on matched registry analysis; exact terminology not specified by authors.","value_numeric":null},{"paper_doi":"10.1097/inf.0000000000005109","tag_type":"warning","value":"No myocarditis/pericarditis events occurred in ages 6–11, limiting risk estimation in that group.","value_numeric":null}],"summaries":{"what_studied":"A population-based matched cohort in Madrid linked health registries to compare 240-day risks after mRNA COVID-19 vaccination versus 5 matched controls in children 6–11 (n=183,273 vaccinated; 916,365 controls) and adolescents 12–17 (n=277,561 vaccinated; 1,387,805 controls). Outcomes were COVID-19 hospitalization, MIS-C, and myocarditis/pericarditis, with effectiveness defined as 1 minus the risk ratio.","key_result":"Ages 6–11: COVID-19 hospitalization risk difference −1.2 per 100,000 (95% CI −6.6 to 4.0), effectiveness 9% (−36 to 49); MIS-C risk difference −1.4 per 100,000 (−4.7 to 2.3), effectiveness 27% (−54 to 76); no myocarditis/pericarditis cases. Ages 12–17: COVID-19 hospitalization risk difference −5.3 per 100,000 (−9.0 to −2.0), effectiveness 45% (18 to 72); MIS-C risk difference −1.3 per 100,000 (−3.0 to 0.8), effectiveness 42% (−31 to 83); myocarditis/pericarditis risk ratio 1.09 (0.60 to 1.70).","practice_takeaway":"In this large Madrid cohort, absolute benefits of mRNA vaccination in children were small, with a clearer reduction in hospitalization among adolescents. MIS-C reductions were small, and there was no myocarditis signal in 6–11 years and no clear increase in 12–17 years over 240 days."}}],"initialOffset":9,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Multisystem Inflammatory Syndrome in Children"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Multisystem Inflammatory Syndrome in Children"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Multisystem Inflammatory Syndrome in Children"}}}]]

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